Tinidazole


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Bacterial vaginosis; Giardiasis; Trichomoniasis; Acute necrotising ulcerative gingivitis 2 g as single dose. Anaerobic bacterial infections 2 g on 1st day, then 1 g/day or 500 mg bid, for 5-6 days. Prophylaxis of post-op anaerobic bacterial infections 2 g, 12 hr before surgery. Eradication of H. pylori associated w/ peptic ulcer disease 500 mg bid, w/ clarithromycin and omeprazole for 7 days. Intestinal amoebiasis 2 g/day for 2-3 days. Hepatic amoebiasis 1.5-2 g/day for 3-6 days.
Dosage Details
Oral
Anaerobic bacterial infections
Adult: 2 g on the 1st day, followed by 1 g daily or 500 mg bid, for 5-6 days.

Oral
Bacterial vaginosis
Adult: 2 g as single dose. May also be given as 2 g for 2 consecutive days or 1 g daily for 5 days.

Oral
Prophylaxis of postoperative anaerobic bacterial infections
Adult: 2 g as single dose 12 hr before surgery.

Oral
Acute necrotising ulcerative gingivitis, Trichomoniasis
Adult: 2 g as single dose. In trichomoniasis, sexual partners should be treated at the same time.

Oral
Intestinal amoebiasis
Adult: 2 g daily for 2 or 3 days.
Child: >3 yr 50-60 mg/kg daily for 3 consecutive days. Max: 2 g/day.

Oral
Hepatic amoebiasis
Adult: 1.5-2 g daily for 3-6 days.
Child: >3 yr 50-60 mg/kg daily for 5 days. Max: 2 g/day.

Oral
Giardiasis
Adult: 2 g as single dose.
Child: >3 yr 50-75 mg/kg as single dose, repeat if necessary. Max: 2 g/day.

Oral
Eradication of H. pylori associated with peptic ulcer disease
Adult: 500 mg bid, given w/ clarithromycin and omeprazole for 7 days.
Renal Impairment
Haemodialysis: Additional dose equal to half the usual dose at the end of haemodialysis.
Administration
Should be taken with food. Take during or immediately after meals.
Contraindications
1st trimester of pregnancy and lactation.
Special Precautions
Patient w/ current or a history of blood dyscrasias. Pregnancy (2nd and 3rd trimester). Hepatic and renal impairment.
Adverse Reactions
Transient leucopenia, ataxia, convulsions, dizziness, headache, hypesthesia, paraesthesia, peripheral neuropathy, sensory disturbances, vertigo, metallic taste, flushing, abdominal pain, anorexia, diarrhoea, furry tongue, glossitis, nausea, stomatitis, vomiting, dark urine, fever, tiredness.
Potentially Fatal: Hypersensitivity.
MonitoringParameters
Monitor total and differential leukocyte counts. Closely monitor childn when treatment duration exceeds 3 days.
Drug Interactions
May potentiate the effects of oral anticoagulants resulting to prolonged prothrombin time.
Food Interaction
Concurrent use w/ alcohol may produce disulfiram-like reaction (e.g. flushing, abdominal cramps, vomiting, tachycardia). Food may delay the rate of absorption.
Lab Interference
May interfere w/ AST, ALT, triglycerides, glucose, and LDH testing.
Action
Description: Tinidazole, a 5-nitroimidazole derivative w/ antimicrobial actions similar to metronidazole, is active against both protozoa (e.g. Trichomonas vaginalis, Entamoeba histolytica and Giardia lamblia) and obligate anaerobic bacteria. It damages DNA strands or inhibits DNA synthesis in microorganism.
Pharmacokinetics:
Absorption: Rapidly and almost completely absorbed from the GI tract. Food may delay absorption. Time to peak plasma concentration: 2 hr.
Distribution: Widely distributed into body tissues and fluids. Crosses the placenta and blood-brain barrier; enters breast milk. Volume of distribution: 50 L. Plasma protein binding: 12%.
Metabolism: Hepatically metabolised primarily via CYP3A4 isoenzyme. Undergoes oxidation, hydroxylation and conjugation; converted to an active hydroxy metabolite.
Excretion: Via urine (20-25%) as unchanged drug and metabolites and faeces (12%). Plasma elimination half-life: 12-14 hr.
Chemical Structure

Chemical Structure Image
Tinidazole

Source: National Center for Biotechnology Information. PubChem Database. Tinidazole, CID=5479, https://pubchem.ncbi.nlm.nih.gov/compound/Tinidazole (accessed on Jan. 23, 2020)

Storage
Store between 20-25°C. Protect from light.
References
Anon. Tinidazole. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 04/07/2014.

Buckingham R (ed). Tinidazole. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/07/2014.

Tindamax Tablet, Film Coated (Mission Pharmacal Company). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 04/07/2014.

Wickersham RM. Tinidazole. Facts and Comparisons [online]. St. Louis, MO. Wolters Kluwer Clinical Drug Information, Inc. https://www.wolterskluwercdi.com/facts-comparisons-online/. Accessed 04/07/2014.

Disclaimer: This information is independently developed by MIMS based on Tinidazole from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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